Individual
DR. BRIAN JOSEPH GLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5301 VETERANS MEMORIAL PKWY, STE 104, SAINT PETERS, MO 63376-2298
(636) 939-3362
(636) 939-3687
Mailing address
PO BOX 7412025, CHICAGO, IL 60674-2025
(636) 939-3362
(636) 939-3687
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2022026389
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200070414
—
MO
Enumeration date
03/19/2019
Last updated
04/18/2025
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